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Objective:To explore the clinical value of point-of-care ultrasonography(PoCUS) in the diagnosis of acute pulmonary embolism(PE).Methods:Consecutive 196 patients suspected of acute PE were enrolled in East Branch, the Second Hospital of Hebei Medical University from January 2017 to November 2017. All the patients were categorized into no PE group( n=143) and PE group( n=53) based on CTPA results. PoCUS was performed and considered diagnostic for PE if one or more right ventricular dysfunction (right ventricular dilation, right ventricular free wall hypokinesia, increased tricuspid regurgitation velocity or decreased tricuspid annular plane systolic excursion), deep venous thrombosis(DVT) or subpleural infarcts were detected. Results:With CTPA as the gold standard for diagnosis, the sensitivity (94.34%), Youden index (0.531) and the area under the ROC curve(AUC) (0.765) of the combined diagnosis of PE by transthoracic echocardiography(TTE), lower limb vein compression ultrasonography(CUS) and lung ultrasonography (LUS) were the highest. The specificity (94.41%) and accuracy (81.63%) of LUS in the diagnosis of PE were the highest, and the misdiagnosis rate (5.59%) of LUS the lowest. The sensitivity of the combined triple PoCUS (TTE, CUS, and LUS) diagnosis of PE was higher than TTE and CUS combined diagnosis ( P=0.016), and the sensitivity and specificity were higher than TTE and CUS combined diagnosis as a whole ( P<0.005). Conclusions:The combined triple PoCUS (TTE, CUS, and LUS) has the highest accuracy in the diagnosis of PE, while LUS has a high specificity and a low misdiagnosis rate in the diagnosis of PE. Therefore, it is recommended to apply the combined triple PoCUS in clinical practice.
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Objective To evaluate the application of atherogenic index of plasma (AIP) and intima-media thickness of carotid artery (CA-IMT) in renal arteriolar sclerosis patients with chronic renal failure.Methods One hundred and twenty nine patients with chronic renal failure patients underwent ultrasound-guided percutaneous renal biopsy from October 2013 to June 2014,the biopsy results showed that renal arteriolar sclerosis was identified in 72 patients (atherosclerosis group) and no renal arterioles sclerosis was detected in 57 patients (non-atherosclerosis group);71 healthy adults were enrolled in the study as controls.The age,height,body weight,systolic and diastolic blood pressure,the indexes of blood lipid and renal function were documented and compared among three groups.The correlation of AIP and CBMmax of common carotid artery and carotid bifurcation with blood lipid level and renal function was analyzed.Results There was significant difference in body weight among patients with atherosclerosis [(70.77 ± 14.27) kg],without atherosclerosis [(60.63 ± 12.12) kg] and the controls [(64.20 ± 8.13) kg] (t =3.071,3.391,all P ＜ 0.05).The TG [(2.43 ± 1.61) mmol/L vs.(1.02 ± 0.37) mmol/L],TC [(7.40 ± 8.80) mmol/L vs.(4.53 ±0.67)mmol/L],LDL-C[(4.40 ±2.13) mmol/L vs.(2.85 ±0.70) mmol/L],AlP[(0.15 ± 0.351) vs.(-0.127 ± 0.184)] of the atherosclerosis group were higher than those of control group (t =5.975,2.252,2.614,-5.467,all P ＜ 0.05).The HDL-C of atherosclerosis group was lower than that of control group [(0.78 ±0.16) mmol/L vs.(1.29 ±0.21) mmol/L,t =4.750,P ＜0.05].The Scr[(117.24 ± 94.27) mmol/L vs.(64.16 ± 13.42) mmol/L],BUN [(6.73 ± 3.58) mmol/L vs.(4.66 ± 1.08) mmol/L] of the atherosclerosis group were higher,and the GFR was lower [(65.60 ±23.00)ml · min-1 · 1.73 m-2 vs.(124.78 ± 24.35)ml · min-1l.73 m-2,t =5.118] than those of control group (t =4.730,4.702).The Scr of the atherosclerosis group was higher,and the GFR was lower [(65.60 ± 23.00) ml · min-1 · 1.73 m-2 vs.(95.60±53.00)ml · min-1 · 1.73 m-2,t =3.514] than those of the non-atherosclerosis group [(117.24 ± 94.27) mmol/L vs.(71.35 ± 42.18) mmol/L,t =3.690].There were positive correlation between TG and LDL-C (r =0.828,0.323,P ＜ 0.05) and negative correlation between AIP and HDL-C (r =-0.489,P ＜0.05).There was positive correlation of CBMmax with Scr,BUN and AIP (r =0.394,0.289,0.528,all P ＜ 0.05),and negative correlation between CBMmax and GFR (r =-0.277,P ＜ 0.05).Conclusion Body weight,GFR,AIP and CBMmax are useful indicators in evaluation of renal arteriolar sclerosis in patients with chronic renal failure.AIP is a sensitive index for abnormal blood lipid level.AIP and CBMmax are important risk factors in chronic renal failure patients with renal arteriolar sclerosis.
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BACKGROUND:Urine-derived stem cels are most likely to come from the kidney tissue, and therefore, these cels are more adaptable to kidney microenvironment, providing a new option for the treatment of kidney diseases. OBJECTIVE: To explore the therapeutic efficacy of human urine-derived stem cels on chronic nephropathy rats. METHODS:The fresh urine samples of healthy people were colected, and then human urine-derived stem cels were extracted and cultured in vitro. Twenty Sprague-Dawley rats were used to prepare chronic nephropathy models, and given injection of human urine-derived stem cel suspension (experimental) or normal saline (control) into the renal cortex, respectively. Another 10 healthy rats were used as controls. Therapeutic effects on renal function were assessed by detection of serum creatinine level and glomerular filtration rate in the three groups. The kidney tissues of rats were taken and observed histomorphologicaly in each group. RESULTS AND CONCLUSION: Human urine-derived stem cels were found to remarkable improve rat’s renal function as wel as reduce the histomorphological changes in the kidney tissues of rats. Compared with the control group, the serum creatinine level was decreased while the glomerular filtration rate was increased significantly in the experimental group; CD68 expression and infiltration of interstitial inflammatory cels were also markedly reduced in the experimental group. To conclude, human urine-derived stem cels can improve the renal function of chronic nephropathy rats.
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OBJECTIVE: To prepare the inclusion compound of diclofenac sodium (DFS)-β-cyclodextrin (β-CD) and investigate its properties. METHOD: The inclusion compound of DFS-β-CD was prepared by the co-precipitation method. RESULTS: The inclusion compound of DFS-β-CD was confirmed by UV absorption spectrum, IR absorption spectroscopy, differential scanning calorimetry (DSC) and phase solubility diagram. Meanwhile, the content analysis of the inclusion compound showed that the molecular ratio of DFS to β-CD was 1∶1. CONCLUSION: The soluability and dissolution rate of DFS were increased and its irritation to stomach was reduced when the drug was included by β-CD.